Art can heal PTSDs invisible wounds Melissa Walker

You are a high-ranking
military service member

deployed to Afghanistan.

You are responsible for the lives

of hundreds of men and women,

and your base is under attack.

Incoming mortar rounds
are exploding all around you.

Struggling to see
through the dust and the smoke,

you do your best to assist the wounded

and then crawl to a nearby bunker.

Conscious but dazed by the blasts,

you lay on your side and attempt
to process what has just happened.

As you regain your vision,

you see a bloody face

staring back at you.

The image is terrifying,

but you quickly come to understand

it’s not real.

This vision continues to visit you
multiple times a day and in your sleep.

You choose not to tell anyone
for fear of losing your job

or being seen as weak.

You give the vision a name,

Bloody Face in Bunker,

and call it BFIB for short.

You keep BFIB locked away in your mind,

secretly haunting you,

for the next seven years.

Now close your eyes.

Can you see BFIB?

If you can, you’re beginning
to see the face

of the invisible wounds of war,

commonly known
as post-traumatic stress disorder

and traumatic brain injury.

While I can’t say I have
post-traumatic stress disorder,

I’ve never been a stranger to it.

When I was a little girl, I would visit
my grandparents every summer.

It was my grandfather

who introduced me to the effects
of combat on the psyche.

While my grandfather was serving
as a Marine in the Korean War,

a bullet pierced his neck
and rendered him unable to cry out.

He watched as a corpsman passed him over,

declaring him a goner,

and then leaving him to die.

Years later, after his
physical wounds had healed

and he’d returned home,

he rarely spoke of his
experiences in waking life.

But at night I would hear him
shouting obscenities

from his room down the hall.

And during the day I would announce myself
as I entered the room,

careful not to startle or agitate him.

He lived out the remainder of his days

isolated and tight-lipped,

never finding a way to express himself,

and I didn’t yet
have the tools to guide him.

I wouldn’t have a name
for my grandfather’s condition

until I was in my 20s.

Seeking a graduate degree in art therapy,

I naturally gravitated
towards the study of trauma.

And while sitting in class learning
about post-traumatic stress disorder,

or PTSD for short,

my mission to help service members
who suffered like my grandfather

began to take form.

We’ve had various names
for post-traumatic stress

throughout the history of war:

homesickness,

soldier’s heart,

shell shock,

thousand-yard stare, for instance.

And while I was pursuing my degree,
a new war was raging,

and thanks to modern body armor
and military vehicles,

service members were surviving
blast injuries they wouldn’t have before.

But the invisible wounds
were reaching new levels,

and this pushed military doctors
and researchers

to try and truly understand the effects
that traumatic brain injury, or TBI,

and PTSD have on the brain.

Due to advances
in technology and neuroimaging,

we now know there’s
an actual shutdown in the Broca’s,

or the speech-language area of the brain,
after an individual experiences trauma.

This physiological change,

or speechless terror as it’s often called,

coupled with mental health stigma,

the fear of being judged

or misunderstood,

possibly even removed
from their current duties,

has led to the invisible struggles
of our servicemen and women.

Generation after generation of veterans

have chosen not to talk
about their experiences,

and suffer in solitude.

I had my work cut out for me
when I got my first job

as an art therapist at the nation’s
largest military medical center,

Walter Reed.

After working for a few years
on a locked-in patient psychiatric unit,

I eventually transferred to the National
Intrepid Center of Excellence, NICoE,

which leads TBI care
for active duty service members.

Now, I believed in art therapy,

but I was going to have
to convince service members,

big, tough, strong, manly military men,

and some women too,

to give art-making as
a psychotherapeutic intervention a try.

The results have been
nothing short of spectacular.

Vivid, symbolic artwork

is being created
by our servicemen and women,

and every work of art tells a story.

We’ve observed that the process
of art therapy bypasses

the speech-language issue with the brain.

Art-making accesses the same sensory
areas of the brain that encode trauma.

Service members can use the art-making
to work through their experiences

in a nonthreatening way.

They can then apply words
to their physical creations,

reintegrating the left
and the right hemispheres of the brain.

Now, we’ve seen this can work
with all forms of art –

drawing, painting, collage –

but what seems to have the most impact

is mask-making.

Finally, these invisible wounds
don’t just have a name,

they have a face.

And when service members
create these masks,

it allows them to come to grips,
literally, with their trauma.

And it’s amazing
how often that enables them

to break through the trauma
and start to heal.

Remember BFIB?

That was a real experience
for one of my patients,

and when he created his mask,

he was able to let go
of that haunting image.

Initially, it was a daunting process
for the service member,

but eventually he began
to think of BFIB as the mask,

not his internal wound,

and he would go to leave each session,

he would hand me the mask,
and say, “Melissa, take care of him.”

Eventually, we placed BFIB in a box
to further contain him,

and when the service member
went to leave the NICoE,

he chose to leave BFIB behind.

A year later, he had only seen BFIB twice,

and both times BFIB was smiling

and the service member
didn’t feel anxious.

Now, whenever that service member
is haunted by some traumatic memory,

he continues to paint.

Every time he paints
these disturbing images,

he sees them less or not at all.

Philosophers have told us
for thousands of years

that the power to create

is very closely linked
to the power to destroy.

Now science is showing us
that the part of the brain

that registers a traumatic wound

can be the part of the brain
where healing happens too.

And art therapy is showing us
how to make that connection.

We asked one of our service members

to describe how mask-making
impacted his treatment,

and this is what he had to say.

(Video) Service Member:
You sort of just zone out into the mask.

You zone out into the drawing,

and for me, it just released the block,

so I was able to do it.

And then when I looked at it
after two days, I was like,

“Holy crap, here’s the picture,
here’s the key, here’s the puzzle,”

and then from there it just soared.

I mean, from there
my treatment just when out of sight,

because they were like,
Kurt, explain this, explain this.

And for the first time in 23 years,

I could actually talk about stuff
openly to, like, anybody.

I could talk to you about it
right now if I wanted to,

because it unlocked it.

It’s just amazing.

And it allowed me to put 23 years of PTSD

and TBI stuff together in one place

that has never happened before.

Sorry.

Melissa Walker: Over the past five years,

we’ve had over 1,000 masks made.

It’s pretty amazing, isn’t it?

Thank you.

(Applause)

I wish I could have shared
this process with my grandfather,

but I know that he would be thrilled

that we are finding ways

to help today’s and tomorrow’s
service members heal,

and finding the resources within them

that they can call upon

to heal themselves.

Thank you.

(Applause)

您是

部署到阿富汗的高级军人。

你要为数百名男女的生命负责

,你的基地受到攻击。

来袭的迫击炮弹
在你周围爆炸。

挣扎着
看穿尘土和烟雾,

你尽力帮助伤员

,然后爬到附近的掩体。

有意识但对爆炸感到茫然,

你躺在你身边,
试图处理刚刚发生的事情。

当你恢复视力时,

你会看到一张血淋淋的脸正

盯着你看。

画面很吓人,

但你很快就会明白

这不是真的。

这个愿景
每天都会在你的睡眠中多次拜访你。

你选择不告诉任何人
,因为害怕失去工作

或被视为软弱。

你给这个愿景起了一个名字,

Bloody Face in Bunker

,简称为 BFIB。 在接下来的七年里,

你一直把 BFIB 锁在你的脑海里

,秘密地困扰着你

现在闭上你的眼睛。

你能看到BFIB吗?

如果可以,您将
开始看到

战争的无形伤口,

通常
称为创伤后应激障碍

和创伤性脑损伤。

虽然我不能说我患有
创伤后应激障碍,但

我对它从来都不陌生。

当我还是个小女孩的时候,我每年夏天都会去看望
我的祖父母。

是我的祖父

向我介绍
了战斗对心理的影响。

当我的祖父
在朝鲜战争中担任海军陆战队员时,

一颗子弹刺穿了他的脖子
,使他无法哭泣。

他看着一个医疗兵从他身边走过,

宣布他死了,

然后让他死去。

多年后,在他的
身体伤口愈合

并回到家中后,

他很少谈及他
在清醒生活中的经历。

但到了晚上,我会

听到他在走廊另一头的房间里大声喊脏话。

白天,
当我进入房间时,我会宣布自己,

小心不要惊吓或激怒他。

他在余下的日子里

与世隔绝,守口如瓶,

从未找到表达自己的方式,

而我还
没有指导他的工具。

直到我 20 多岁,我才知道我祖父的病情。

寻求艺术治疗的研究生学位,

我自然而然地
倾向于研究创伤。

在课堂上
学习创伤后应激障碍(

简称 PTSD)时,

我帮助
像我祖父一样遭受痛苦的军人的使命

开始形成。

在整个战争历史中,我们对创伤后压力有不同的称呼:例如

思乡之情、

士兵的心、

炮弹冲击、

千码凝视。

当我攻读学位时,
一场新的战争正在肆虐

,多亏了现代防弹衣
和军用车辆,

服役人员在爆炸伤中幸存下来,
他们以前不会有。

但无形的
伤口达到了新的水平

,这促使军医
和研究

人员尝试并真正
了解创伤性脑损伤或 TBI

和 PTSD 对大脑的影响。

由于
技术和神经影像学的进步,

我们现在知道在个人经历创伤后
,布洛卡

或大脑的语言区域实际上会关闭

这种生理变化,

或者通常所说的无言恐怖,

再加上心理健康的耻辱

,害怕被评判

或误解,

甚至可能
从他们目前的职责中解脱出来

,导致
了我们军人和女性的无形斗争。

一代又一代的退伍军人

选择了不
谈论他们的经历,

并在孤独中受苦。

当我在美国最大的军事医疗中心 Walter Reed 获得第一份艺术治疗师工作时,我的工作已经完成


一个封闭的精神病院工作了几年后,

我最终转到了
NCoE 国家无畏卓越中心,

该中心负责
为现役军人提供 TBI 护理。

现在,我相信艺术疗法,

但我将
不得不说服

军人,高大、坚韧、强壮、有男子气概的军人,

以及一些女性,

尝试将艺术创作作为
一种心理治疗干预。

结果
简直是惊人的。 我们的军人正在创作

生动、具有象征意义的艺术品

,每件艺术品都讲述着一个故事。

我们观察到
艺术治疗的过程绕过

了大脑的语言问题。

艺术创作访问
大脑中编码创伤的相同感觉区域。

服务成员可以使用艺术创作

一种不具威胁性的方式来处理他们的经历。

然后他们可以将文字应用
到他们的物理创作中,

重新整合
大脑的左右半球。

现在,我们已经看到这可以适用
于所有形式的艺术——

绘画、绘画、拼贴——

但似乎影响最大的

是面具制作。

最后,这些无形的
伤口不仅有名字

,还有脸。

当服务人员
制作这些面具时,

它可以让他们
从字面上理解他们的创伤。

令人惊讶的
是,这使他们

能够打破创伤
并开始愈合的频率。

还记得 BFIB 吗?


对我的一位患者来说是一次真实的经历

,当他制作他的面具时,

他能够
放下那个令人难以忘怀的形象。

最初,对于服务人员来说,这是一个令人生畏的过程

但最终他
开始认为 BFIB 是面具,

而不是他的内部伤口

,他会去每次会议结束,

他会把面具递给我,
然后说,“梅丽莎 , 照顾好他。”

最终,我们将 BFIB 放在了一个盒子里
以进一步收容他,

而当服务人员
离开 NCoE 时,

他选择离开 BFIB。

一年后,他只见过两次BFIB

,两次BFIB都面带微笑

,服务员
也没有感到焦虑。

现在,每当那个服役人员
被一些创伤性记忆困扰时,

他都会继续画画。

每次他画出
这些令人不安的图像时,

他都很少或根本看不到它们。 几千年来,

哲学家们告诉我们

创造

的力量与破坏的力量密切相关。

现在科学向我们

表明,记录创伤性伤口

的大脑部分也可能是发生愈合的大脑部分

艺术疗法正在向我们
展示如何建立这种联系。

我们请我们的一名服务

人员描述面具制作如何
影响他的治疗

,这就是他不得不说的。

(视频)服务员:
你有点像面具一样。

你进入绘图区

,对我来说,它刚刚释放了块,

所以我能够做到。

然后当我在两天后看到它时
,我想,

“天哪,这是图片,
这是钥匙,这是谜题”

,然后它就从那里飙升了。

我的意思是,从那里
我的治疗就在看不见的时候,

因为他们就像,
库尔特,解释这个,解释这个。

23 年来,我第一次

真正可以
公开地谈论事情,比如,任何人。

如果我愿意,我现在可以和你谈谈,

因为它解锁了。

真是太神奇了。

它让我能够将 23 年的 PTSD

和 TBI 的东西放在一个

以前从未发生过的地方。

对不起。

梅丽莎沃克:在过去的五年里,

我们已经制作了 1000 多个口罩。

真是太神奇了,不是吗?

谢谢你。

(掌声)

我希望我能
与我的祖父分享这个过程,

但我知道他会很

高兴我们正在寻找方法

来帮助今天和明天的
服务人员治愈,

并在他们身上找到

他们可以

呼吁治愈的资源 他们自己。

谢谢你。

(掌声)